Yang Ching-Tzu, Liu Hsin-Yun, Shyu Yea-Ing Lotus
Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
Int J Nurs Stud. 2014 Apr;51(4):593-602. doi: 10.1016/j.ijnurstu.2013.09.001. Epub 2013 Sep 13.
Family caregivers of older persons with dementia face negative impacts such as heightened role strain due to care receivers' incremental loss of cognitive function. Dyadic relational resources were found to protect caregivers against negative caregiving outcomes while caring for cancer patients, but had not been explored in caregivers of patients with dementia.
To explore whether the impact of caregiving demand/care receivers' cognitive functioning on caregiver role strain is moderated by dyadic relational resources.
Cross-sectional correlational survey.
The neurological clinics of a 3700-bed medical centre, neurological ward, and day care centre affiliated with a regional hospital in northern Taiwan.
A convenience sample of 219 family caregivers and care receivers with dementia was enrolled, with 197 (90%) completing the study questionnaires.
Data were collected from family caregivers' self-completed questionnaires from December 2010 to November 2011. We examined the moderating effects of caregiving demand/care receiver dementia severity and dyadic relational resources (mutuality, preparedness and predictability) on caregiving outcome (role strain) using hierarchical multiple regression analyses. Moderating effects were examined according to two- and three-way interaction terms in the regressions. We also explored the simple effect of each independent variable on role strain.
The dyadic relational resources of mutuality and preparedness moderated the effects of caregiving demand on caregivers' role strain. That is, a high level of mutuality and preparedness protected caregivers from high levels of role strain, even when caregiving demand was high. Another important factor was a high level of predictability, which tended to decrease role strain. Finally, the association between care receiver cognitive functioning and caregiver role strain was influenced by the level of mutuality between caregiver and care receiver. More specifically, high levels of mutuality diminished role strain in caregivers of patients with mild dementia.
Dyadic relational resources may moderate the effects of role strain. These findings suggest that these dyadic relational resources should be enhanced for family caregivers of patients with dementia to ease their caregiving role strain.
老年痴呆症患者的家庭照顾者面临负面影响，如因受照顾者认知功能逐渐丧失而导致的角色压力加剧。研究发现，二元关系资源可保护照顾癌症患者的照顾者免受负面照顾结果的影响，但尚未在痴呆症患者的照顾者中进行探讨。
探讨二元关系资源是否能调节照顾需求/受照顾者认知功能对照顾者角色压力的影响。
横断面相关性调查。
台湾北部一家拥有3700张床位的医疗中心的神经科诊所、神经科病房和一家地区医院附属的日间护理中心。
选取219名痴呆症患者的家庭照顾者及其受照顾者作为便利样本，其中197人（90%）完成了研究问卷。
2010年12月至2011年11月期间，通过家庭照顾者自行填写问卷收集数据。我们使用分层多元回归分析，检验了照顾需求/受照顾者痴呆严重程度和二元关系资源（相互性、准备度和可预测性）对照顾结果（角色压力）的调节作用。根据回归中的双向和三向交互项检验调节作用。我们还探讨了每个自变量对角色压力的简单效应。
相互性和准备度这两种二元关系资源调节了照顾需求对照顾者角色压力的影响。也就是说，即使照顾需求很高，高水平的相互性和准备度也能保护照顾者免受高水平的角色压力。另一个重要因素是高水平的可预测性，这往往会减轻角色压力。最后，照顾者与受照顾者之间的相互性水平影响了受照顾者认知功能与照顾者角色压力之间的关联。更具体地说，高水平的相互性减轻了轻度痴呆症患者照顾者的角色压力。
二元关系资源可能会调节角色压力的影响。这些发现表明，应增强痴呆症患者家庭照顾者的这些二元关系资源，以减轻他们的照顾角色压力。
